Yes, Hashimoto's Can Take Your Hair
Hair loss is one of the most concerning symptoms that patients with Hashimoto's have to deal with.
It's right up there with weight gain and fatigue and it's something that I get emails and questions about on a weekly if not daily basis.
Here's why it's a problem:
Because Hashimoto's thyroiditis is a disease of the thyroid gland it can and does impact your hair.
As Hashimoto's ravages your thyroid gland, destroying it from the inside out, your thyroid gland will eventually have problems producing enough thyroid hormone.
You'll start to experience the symptoms of hypothyroidism.
As your thyroid levels fall you will see changes to the quality and texture of your hair and may even experience hair loss.
This symptom is so common that as many as 60 to 70% of patients with Hashimoto's will experience it.
The hair loss associated with Hashimoto's can range from mild (just noticing a few extra hairs coming out when you take a shower) to serious hair loss which leads to thinning of the entire head.
While hair loss may not be the most pressing symptom in terms of its impact on your overall health it is still very important because of its impact on your psychological well-being.
And that's exactly why we are talking about this subject in detail right now.
Today you will learn:
- The 3 main types of hair loss and patterns of hair loss that Hashimoto's patients experience.
- How these types of hair loss differ and why it's important to understand which type you have.
- The 4 main causes of hair loss (these are different from the types of hair loss!).
- Tips and tricks to manage each of these types of hair loss.
- Supplements and other treatments that can help stop hair fall and help you regrow your hair.
Let's jump in...
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3 Main Types of Hair Loss Found in Hashimoto's Patients
You can think about the types of hair loss more as patterns of hair loss.
These types of hair loss really just explain more about where you are losing hair and what that means for your body.
And, believe it or not, this information is very important because the pattern of hair loss you are experiencing can often lead you to the cause.
It doesn't work all of the time and it isn't perfect (which is why we will discuss the various causes of hair loss below) but it's still helpful information.
When it comes to hair loss and Hashimoto's there are 3 main types of hair loss that most patients experience.
These have some funny medical names but don't let that confuse you as they are very simple to understand:
- Telogen effluvium - This is just a fancy name used to describe diffuse hair loss (1) over your entire head. Diffuse is just a word used to describe evenly throughout. So, said another way, this type of hair loss results in hair loss that occurs evenly throughout your entire head. Telogen effluvium is the most common cause of hair loss among patients with Hashimoto's and it's probably the reason (2) you are losing extra hair when you shower or when you brush your hair.
- Alopecia areata - This is the type of autoimmune hair loss that can occur in patients with Hashimoto's (3). It causes hair loss like telogen effluvium but the pattern is much different. The hair loss here results in patchy or circular areas of hair loss usually on the scalp. It can vary in terms of its size and exact location but when it is present it resembles a bald spot.
- Androgenetic alopecia - The last one is a form of hair loss caused by hormone imbalance (4) and typically results in hair loss that resembles male pattern baldness. While this pattern of hair loss is frequently seen in men, it can also be seen in women and occurs for similar reasons. Women with male pattern baldness may experience a receding hairline, thinning hair around the temples, and even hair loss on the back of their head. Sometimes this type of hair loss can also be accompanied by hair growth on the face, chin, or upper lip as well.
The reason we care so much about these types of hair loss is because each one has a slightly different treatment.
And by looking at the pattern of hair loss you are experiencing, you can often narrow down the cause which will help determine your treatment.
As you read the list of types of hair loss did you find that one matched the type of hair loss you are currently experiencing?
What makes managing Hashimoto's hair loss difficult is that these types of hair loss can often overlap with one another which means it's not uncommon for someone to experience one or more types of hair loss simultaneously.
For instance, you may experience both telogen effluvium (diffuse hair loss) with some elements of androgenetic alopecia (male pattern baldness).
This can obviously make treatment slightly more confusing and difficult which is why we also need to talk about the causes.
4 Main Causes of Hair Loss in Hashimoto's Thyroiditis
When it comes to Hashimoto's there are 4 main causes of hair loss that most patients will experience:
#1. Decreased Thyroid Function
Hands down the most common cause of hair loss experienced in Hashimoto's is due to decreased thyroid function.
This hair loss is pretty straightforward and occurs because your body isn't producing enough thyroid hormone.
As thyroid hormone levels fall, from damage to your thyroid gland, you will see a negative change in your hair.
This cause of hair loss is classified as telogen effluvium and usually occurs over the entire head and can even impact other areas such as your eyebrows.
What this means is that if you have hair loss and Hashimoto's, and you are losing hair over your entire head, then it's probably from telogen effluvium and it's probably from your thyroid.
Understanding this type of hair loss is easy, fixing it isn't.
The key to fixing diffuse hair loss from low thyroid function is to improve how well your thyroid is working.
If your preferred method is to take thyroid medication so you can immediately boost your thyroid function up, that's also fine.
It doesn't really matter so long as you do something which increases how much thyroid hormone is circulating in your body.
As you bring your thyroid levels up you should see a reduction in hair loss as well as an improvement in hair quality.
In theory, it's pretty simple:
Hypothyroidism (or low thyroid) leads to hair loss so the solution is to bring that thyroid function back up to a normal level.
Even though it sounds easy, it can be tricky to get your thyroid optimized.
When using thyroid medications you must find what I call a Goldilocks level.
You need just enough medication to replace the lost thyroid hormone you are missing but not too much to result in hyperthyroid symptoms which can trigger hair loss from hyperthyroidism.
And reaching this balance can be difficult, especially if you are working with a doctor that isn't up to date on thyroid management.
This is the biggest issue when trying to optimize your thyroid using thyroid medication.
The difficulty in going the natural route is not that it doesn't work but that it can take a while.
Taking prescription thyroid medication provides your body with an immediate boost to thyroid hormone in your body.
Healing your thyroid naturally can and does work (for many people) but it takes many months to years to see serious improvement.
And if you are someone who is trying to fix your hair rapidly, it often makes more sense to use thyroid medication to optimize thyroid function so you don't have to wait that length of time to see results.
Let's face it:
Most people want to see a stop to their hair loss right now, they don't want to wait 12 months.
One final thing to consider, if you want to go the all-natural route, is how long you've had Hashimoto's.
Because Hashimoto's is ultimately a progressive disease it will eventually cause permanent damage to your thyroid gland.
The more permanent damage that occurs the more difficult it will be to use natural therapies and the more likely you are to need medication.
If you are someone who has had Hashimoto's for 10+ years then you'll probably need some medication due to this problem.
#2. Autoimmune-Related Hair Loss
If you have one autoimmune disease you are much more likely to get another.
That's just how the statistics play out, unfortunately.
And if you are someone reading this, you already have one strike against you because you have Hashimoto's.
But in addition to Hashimoto's, you are more likely to develop other autoimmune diseases simply because you already have Hashimoto's.
Other autoimmune conditions that tend to pair with Hashimoto's include:
- Hashimoto's and Celiac Disease (5) (gluten autoimmune disease)
- Hashimoto's and Vitiligo (6) (depigmentation of the skin)
- Hashimoto's and alopecia areata (7) (hair loss)
- Hashimoto's and pernicious anemia (8) (low iron)
- Hashimoto's and immune thrombocytopenia (9) (low platelets)
The one I want to focus on today is alopecia areata.
Alopecia areata is an autoimmune type of hair loss that can occur in anyone but tends to occur in those with Hashimoto's more frequently compared to the regular population.
In this autoimmune disease, your own immune system attacks your hair follicles which destroys them and results in hair loss over time.
Hair loss from alopecia areata is completely different from the hair loss caused by low thyroid function both in its cause and pattern.
Unfortunately, hair loss secondary to alopecia areata is more difficult to treat compared to some of the other types of hair loss we will discuss today.
Even though it's more difficult to treat, it's the least common cause of hair loss among patients with Hashimoto's.
So from a statistical standpoint, it's much more likely that your hair loss is caused by something else other than this condition.
If you are one of the unlucky few who are experiencing this type of hair loss, all hope is not lost.
The key to treating it is to focus on balancing and optimizing your immune system.
Much like Hashimoto's, alopecia areata stems from an imbalance in your immune system.
If you can bring balance back to that system and cool down inflammatory pathways then you may be able to stop your own body from destroying your hair follicles.
The good news is that the same treatments that you'll use to balance your immune system for alopecia may also help in treating the autoimmune component of Hashimoto's as well.
Treatments that may help balance immune function include:
- Removing inflammatory foods from your diet
- Consuming whole foods or eating a whole food diet
- Optimizing Vitamin D levels
- Taking anti-inflammatory supplements
- Taking supplements that your immune system needs to function optimally
- Optimizing gut health
- Fasting (water fasting, intermittent fasting, OMAD, and/or prolonged fasting)
- And stress reduction (just to name a few)
Lastly, remember this important point:
If you have alopecia areata then taking thyroid medication will not reverse your hair loss!
It will help improve your thyroid and may somewhat help the quality of your hair but you won't see significant improvement in hair loss until you target your immune system.
#3. Hormone Imbalances
Hormone imbalances in your sex hormones can also result in hair loss.
This category really goes hand in hand with androgenetic alopecia which results from changes to your testosterone levels.
High levels of testosterone or inappropriate metabolism of testosterone to more powerful androgen metabolites can trigger androgenetic hair loss.
Why are Hashimoto's patients prone to experience this type of hair loss?
Because your thyroid helps to regulate many important hormone systems including testosterone.
Women who have Hashimoto's are at increased risk for developing issues in testosterone levels as well as testosterone metabolism both of which may contribute to this type of hair loss.
At baseline, men tend to have more testosterone than women (10) which is why they tend to experience male pattern baldness (the pattern of hair loss we discussed above).
But women can experience this type of hair loss as well, especially when their sex hormones are imbalanced.
In addition to testosterone, estrogen and progesterone may also play a role in hair growth and hair loss (11) as well.
Much like testosterone, Hashimoto's can also cause low or high levels of either.
The good news is that fixing these hormone imbalances usually starts by fixing your thyroid.
As you improve thyroid function you should see improvement in your sex hormone levels.
This assumes, though, that you don't have other conditions on top of your Hashimoto's such as PCOS.
In cases where you have other conditions or syndromes contributing to hormone imbalance, fixing your thyroid may not be sufficient to solve your hair loss without also addressing that other condition.
No matter what, though, if you have Hashimoto's and hair loss you will want to get your sex hormones tested.
You can do that by ordering the following:
Ordering these tests will tell you if you have a problem with any of these hormones!
If you do, then you know that your sex hormones are probably playing some role in your hair loss.
Before you jump down the rabbit hole of treating these hormones, make sure you start first with your thyroid.
Optimizing your thyroid often naturally helps to improve your sex hormones and may, therefore, stop or slow your hair loss.
#4. Nutrient Deficiencies
Lastly, we need to talk about nutrient deficiencies.
Broad nutrient deficiencies (of all types) are very common among patients with Hashimoto's because of how disordered thyroid states impact gut health and intestinal absorption of nutrients.
It's VERY common for Hashimoto's patients to experience multiple nutrient deficiencies including some nutrients that may impact their hair.
Even though these nutrient deficiencies are common, it is not common that they would cause hair loss all by themselves.
Instead, they are more likely to be contributing to your hair loss in conjunction with one of the other three causes mentioned above.
While nutrient deficiencies certainly can CAUSE hair loss by themselves, I find that they more frequently limit how well your hair responds to the treatments we have already discussed.
Because of this, it's almost always a good idea to check on some basic nutrient levels and use some basic supplements when you are trying to regrow your hair.
Some of the more important hair regrowth nutrients include:
- Iron (and Ferritin) - Iron is probably the most important (12) when it comes to hair growth. It's been shown that a certain amount of iron is required in order for your hair to grow. We also know that patients with Hashimoto's are at increased risk for developing iron deficiency for a number of reasons. Because of this, make sure to check your ferritin level (which is a marker of iron storage) to see if you need an iron supplement. For reference, the optimal range for ferritin is somewhere around 40-70 mcg/L (13) and healthy women who don't have any issues with hair loss have a ferritin level of around 77 mcg/L. It's a good idea to aim for somewhere in this range but don't just blindly supplement with iron as it can cause problems if you take too much! Check your ferritin and iron studies first and then supplement only if necessary.
- Zinc and Selenium - I've discussed the benefits of zinc and selenium for thyroid function in many other articles but it also turns out that they are important cofactors required for hair growth (14). When you consider that taking these supplements can also help lower your thyroid antibodies, normalize your immune system, and improve hair quality, they become a no-brainer to take for most thyroid patients. For these reasons and many others, I included zinc and selenium in many of my thyroid-specific supplements. Unlike iron, you don't automatically need to test your levels before using these supplements. They are quite safe and often very effective for most thyroid patients.
- Vitamin B12 (and other B Vitamins) - Vitamin B12 as well as many other B vitamins are also important for hair growth (15) and another set of nutrients that Hashimoto's patients frequently don't get enough of. If you are someone who knows they have a B12 deficiency (or if you are someone who felt better when using B12) then you may want to consider taking a B complex to make sure all of your B levels are optimized. Biotin, also known as vitamin B7, is often placed in hair regrowth supplements because of the important role that it plays in hair growth and hair metabolism.
Get Your Hair Back
If you go over these 3 main types of hair loss and 4 main causes of hair loss you should be able to figure out where you fit in.
You should be able to match the pattern or type of hair loss you are experiencing which will then help you figure out a likely cause.
Once you have that information the only thing that you need to do is target your treatment!
Whether that is optimizing your thyroid function through the use of thyroid medications or natural therapies, balancing your immune system with the use of supplements or lifestyle changes, or balancing your sex hormones, you should have a pretty good idea of where to start.
With very few exceptions, I have been able to use this framework to help Hashimoto's patients with hair loss regrow their hair.
Based on my own experience, this should help at least 95% or more of you reading this.
Unfortunately, there are some patients with Hashimoto's who have very strong genetic components to their hair loss and that particular type of hair loss may not respond to these therapies.
But for most of you, you should be able to see significant improvement using these strategies.
Whether that is helping you to actually regrow your hair, reducing how much hair loss you are experiencing, or slowing down the rate at which you are losing your hair, you should see some improvement.
Now I want to hear from you:
Are you someone with Hashimoto's experiencing hair loss?
If so, what type of hair loss are you experiencing? What type of pattern are you seeing?
Do you have an idea as to what is causing your hair loss?
Are you planning on using any of the treatments listed here?
Leave your questions or comments below!
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